Editorial

Well 2011 has started with a range of confusing and disturbing problems, mostly associated with supply chain issues. And it is likely to get worse as we get other manufacturers following and then variations on the theme involving exclusive deals with specific products. These are disruptive issues for pharmacy and with government PBS reforms grafted over the top, pharmacy is contemplating one issue after the other and wondering how to respond to each. The disruptive policies of manufacturers such as Pfizer are not likely to win them friends in pharmacy and when a considered response is organised, Pfizer stands to permanently lose pharmacy goodwill and an erosion of their own market share as pharmacists drop support for OTC lines and actively channel Pfizer prescription products into alternate generic brands.

Feature Contribution

Pfizer’s actions expose weaknesses of Government methodology

The decision by Pfizer to supply its medicines directly to community pharmacies across Australia clearly exposes the flaws in the way in which successive Governments have managed the supply chain that supports their social welfare policy regarding subsidised medicines for all Australians.Pfizer’s decision to establish an alternative distribution network for its drug portfolio has been made so that when its Lipitor originators come off patent it will have the opportunity to compete for that generic business. The problem Pfizer faces is that two of the three big pharmacy wholesalers have preferred distribution arrangements with generic drug suppliers – API with Alphapharm and Sigma with (now) Aspen. These deals would appear to limit Pfizer’s opportunity to gain market share for its own generics. Given the revenue and profits at risk, it’s difficult to argue with their logic.

Restrictive Distribution Services Will Increase- Time to Reorganise

New supply chain restrictions are liable to hit Australian pharmacy following in the wake of the recent Pfizer distribution bombshell.Recent developments in the UK point to this as an inevitable and worrying problem that looks like embedding itself in the distribution system representing permanent pharmacy disadvantage, particularly for the small to medium sized entities.Australian pharmacy needs to reorganise itself quickly before it finds itself being further gouged for supply chain costs or being disadvantaged in the market place by not having access to particular medicinal products.But first, a brief analysis and some history of the Australian supply chain processes.

Pharma-Goss for February 2011

The time has come to review the level of co-payment being expected of consumers to Pharmaceutical Benefit Scheme (PBS) medicines before they cease to take them and put their health in danger.The real beneficiaries of a co-payment increase are the dispensing pharmacies which make a “windfall” gain every time the co-payment is increased as more PBS items fall into the non PBS claimable area. An additional fee of $3.92 can then be applied to all items less that the copay level of (now) $34.20.[1]The 1st January saw the traditional increase in the co-payment required by general beneficiaries of the PBS using the clause in the National Health Act that indexes the copay level to the Consumer Price Index.[2]A recent article published 0n the Australian Policy Online website[3] shows that increasing co-payments for pharmaceuticals is not good for the health of low income earners.

Power Balance™ and other Bogus Bangles

It was the annual Golfer’s Christmas party. Peeping out from under shirt sleeves, I could see that many of the club members were wearing the latest fad that they clearly hoped would improve their handicap; the Power Balance™ wrist band. In South Australia another bracelet lay abandoned on a kitchen bench top, discarded by its disappointed rheumatoid arthritic suffering owner, who’d purchased it in the hope that it would help restore some of his diminishing strength. He wondered if he was somehow wearing it the wrong way. In NSW, slowing down at traffic lights, I could also see the now familiar adornment on the wrist of a courier driver who pulled up alongside my car. It seems that everyone but me is buying them. Have they finally discovered the synthetic fountain of youth or is this yet another bogus bangle?

Global Mobile Phone Calls- Anywhere, Anytime - And Free!

Flinders University has announced they have developed technology for mobile phones that can work under disaster or breakdown conditions as evidenced in recent floods in Queensland and Victoria, where mobile phone towers simply disappeared.What is really interesting is that it allows messages to be transferred to other mobile phones until one is found that can connect to a tower.But the application has broader potential for health communication and personal use.The inventor's website, (called Serval) announced:

Marketing Focus E-Zine

At all times care must be taken to protect the integrity and the definition of a brand name.Introduction of too many products and services under one brand weakens the market presence and relevance. The term commonly used is "line extension". Colgate and Palmolive are examples where double digit totals of differing products feature one name. Interestingly, many consumers find that confusing rather than reassuring. It is difficult to define what the brand stands for. The recent case studies of the Australian Federal election and the Victorian state election underscore the impact, ramifications and manifestations on the brand. Perhaps the best recent one-liner in the Australian political arena belongs to the Liberal Party's Federal Opposition Leader, Tony Abbott, who declared:

PBS to Indigenous needs a makeover

The current situation for Aboriginal and Torres Strait Islander people accessing the Pharmaceutical Benefits Scheme presents a complicated mix of mainstream programs and tailored measures to suit particular needs. The result is mini bureaucracies established in key stakeholder organisations to deliver programs that do little to help the Indigenous person understand what their medicines are for and why they should take them. The following summarises the current situation and offers suggestions for improvement.

Distribution Disasters- Do They Not Learn From Historical Mistakes?

The Pfizer/DHL distribution model is seemingly not working very well in its first week of introduction. The complaints from community pharmacies are numerous and need to be fixed fast. Unfortunately, the most visible component of the supply chain is a community pharmacy and consumers are the most affected if they are not able to source their prescription drugs. Common complaints for non-delivery of service are:

UK Distribution Problems Compared to Australia

The U.K seems to experience similar distribution problems to Australia in terms of delivery times. In an updated “best practice guidance” published by the UK Department of Health manufacturers, wholesalers, dispensers and prescribers are advised on how they can alleviate problems currently occurring in the supply chain. A copy can be found here. The advice for pharmacies is that they should receive their orders within 24 hours i.e. goods ordered at 1pm today should be in store by 1pm tomorrow.

Young Pharmacists – Undergo Metamorphosis to Solve Ownership Problems

Newly graduated pharmacists are frustrated because the limitations of community pharmacy practice have ensured that the opportunity to develop as a professional pharmacist has been progressively diminished.Some are even facing the prospect of long-term unemployment. Young pharmacists have a range of complex issues to engage with before they can be in the practice of pharmacy through pharmacy ownership, principal among them is insufficient capital. The myriad of regulations that have to be understood and complied with means that there is also a steep learning curve before a young pharmacist acquires the experience to weave in and out of these obstacles. But remember, every problem has its own solution – you just need to think outside the square.

Are You Being Served or Where Have all the Customers Gone?

There is no doubt about it. After many years of hesitancy, online sales are increasing to an extent that far outstrips their “bricks and mortar” counterparts. Sales comparisons between 2009 and 2010 amounted to a 14% increase. With pressure mounting on community pharmacy viability i2P wonders why it has taken pharmacies so long to develop a workable online marketing channel.

Palm-Vein Biometrics Prevents Medical Fraud

All too often, people are victims of identity theft. Less common, but perhaps more dangerous, is the growing trend of medical identity fraud. According to an US FTC report, three percent of all identity theft victims in 2005 were victims of medical identity theft — which means of the 8.3 million ID theft victims that year, approximately 250,000 people were victimised by medical identity theft. Victims do not normally realise that they have been victimised — unless they get a hospital bill for a procedure they never received.What is even more troubling, however, is that doctors might make incorrect diagnoses based on data from the identity thief's medical history.

Conservation icons face regular climate extremes: study

Climate change this century is expected to place substantial strain on the integrity and survival of some of the world's biologically important conservation regions, with most experiencing monthly climate conditions that were considered extreme in the recent past, says a new study.

Finding ways to protect fish and fishers

Researchers at Australia’s leading coral reef research centre have developed a way to protect both coral reef fish – and the interests of fishers.In pioneering research carried out in Fiji in collaboration with the Wildlife Conservation Society (WCS), the ARC Centre of Excellence for Coral Reef Studies (CoECRS) team has reported a new approach that enables communities to balance the need to protect the environment with the need to maintain local food supplies and incomes.Concern over the worldwide decline of coral reef has prompted many countries and local communities to impose marine reserves to protect dwindling fish stocks.However these can adversely affect the incomes and welfare of fishers and their communities, says lead author Ms Vanessa Adams of CoECRS and James Cook University.

UQ signs agreement with US manufacturer to develop geothermal power technology

UQ's Queensland Geothermal Energy Centre of Excellence has signed an agreement with US turbine and power plant manufacturer Verdicorp to develop technology that is expected to significantly reduce the cost of geothermal electricity. The agreement marks the start of a collaborative project to develop technologies which will help the geothermal sector reduce the cost of geothermal electricity below that of gas-fired electricity and is expected to make geothermal power cost-competitive.

An unexpected benefit of osteoporosis treatment

Australian clinical researchers have noted an extraordinary and unexpected benefit of osteoporosis treatment – that people taking bisphosphonates are not only surviving well, better than people without osteoporosis, they appear to be gaining an extra five years of life. Associate Professor Jacqueline Center and Professor John Eisman, from Sydney’s Garvan Institute of Medical Research, based their findings on data from the long running Dubbo Osteoporosis Epidemiology Study*.

Pharmacist Support Service for the Flood Affected

Pharmacists’ Support Service available to NSW pharmacists affected by flooding.Phone for the cost of a local call: 1300 244 910 between 8am and 11pm.

The Pharmacists’ Support Service (PSS) is temporarily extending its Victorian based service to assist pharmacists affected by the floods in NSW as well as those in Queensland. PSS, a free telephone support service provided by pharmacists for pharmacists, offers a listening ear, information and referral to pharmacists who are experiencing stress and trauma. The service is also discreet and anonymous so callers are free to discuss their situation openly. The volunteer pharmacists who take the calls have all undertaken specialised training in telephone counselling. PSS offers the benefit of peer support as callers know they are on common ground when talking to another pharmacist.

How nasal stem cells might prevent childhood deafness

Australian scientists have shown for the first time in mice that nasal stem cells injected into the inner ear have the potential to reverse or restore hearing during early onset sensorineural hearing loss. Sensorineural hearing loss occurs when hearing cells in the cochlea lose their function. Frequently inherited, and usually starting during infancy and early childhood, the condition can slow a child’s development and lead to speech and language problems.

Acid oceans demand greater reef care

The more humanity acidifies and warms the world's oceans with carbon emissions, the harder we will have to work to save our coral reefs. That's the blunt message from a major new study by an international scientific team, which finds that ocean acidification and global warming will combine with local impacts like overfishing and nutrient runoff to weaken the world's coral reefs right when they are struggling to survive.

Sunnier outlook for MS diagnosis

The Australian love affair with the great outdoors may have contributed to lower rates of multiple sclerosis (MS), according to research from The Australian National University.The Ausimmune Study, coordinated by Associate Professor Robyn Lucas from the ANU College of Medicine, Biology and Environment and involving researchers from across Australia, found that people who spend more time in the sun, and those with higher vitamin D levels, may be less likely to develop MS.

Universal flu vaccine study yields success in mice

Adelaide researchers have taken a step closer to the development of a universal flu vaccine, with results of a recent study showing that a vaccine delivered by a simple nasal spray could provide protection against influenza.University of Adelaide researcher Dr Darren Miller and colleagues have successfully trialled a synthetic universal flu vaccine in mice. The results have appeared this month in a paper in the Journal of General Virology.

Born Again – Elmo de Alwis rises from the ashes

Elmo de Alwis, the personable and well-liked ex-CEO of Sigma Pharmaceuticals Ltd has surfaced as Operations and Strategy Advisor for Generic Health. In this role In his new role, Elmo will be pursuing acquisition opportunities and advising on business strategy and operations effectiveness.

Counterfeit Medicines Being Caught up With

Counterfeit medicines in the northern hemisphere have been increasing in recent times with varying estimates ranging from 1-5% of products distributed by wholesalers being fake. It is believed that counterfeit medicines were a major factor in Pfizer’s decision to go direct, both in the UK and in Australia. The European Parliament has developed a new directive titled “The Falsified Medicines Directive” that now regulates the safety and traceability of medicines, the regulation of Internet pharmacies and the sanctions that can be applied against counterfeiters. For access to the Directive visit http://www.europarl.europa.eu/sides/getDoc.do?type=REPORT&reference=A7-2010-0148&language=EN

Pharmedia - The PGA Role in Pfizer's Disruptive New Business Model

Just in the last days before the 2010 Christmas break, Australian community pharmacy was confronted with a distribution coup engineered by Pfizer. Essentially they announced that they were going to deal direct with individual pharmacies, with revised trading terms that were not going to be as favourable as the existing terms through wholesalers.Nor were they going to deal with wholesalers or pharmacy buying groups.The profession was stunned, but because of the timing of the announcement, it took a few weeks before hard questions began to be asked and reported in various pharmacy media.The Pharmacy Guild of Australia (PGA) was uncharacteristically quiet and then Kos Sclavos, president of the PGA, made a statement through the Pharmacy News publication.It seemed only to surface after other media pressure had built.The enormity of the impications of the Pfizer decision for the whole of the pharmaceutical industry began to hit home as pharmacists began to analyse what was really going on, and the agenda and the flow-on problems that were going to be associated with the decision, in particular for community pharmacies and their wholesalers, also other major manufacturers.The news release follows on below, and i2P has asked Mark Coileman to comment on this unusual train of events.